河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (10): 1139-1143.doi: 10.3969/j.issn.1007-3205.2021.10.005

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miR-145、ABCD2评分联合动脉超声对TIA患者进展为脑梗死的风险评估价值分析

  

  1. 河北省保定市第二医院神经内科，河北 保定 071051
  • 出版日期:2021-10-25 发布日期:2021-10-28
  • 作者简介:余兰(1980-)，男，河北保定人，河北省保定市第二医院主任医师，医学学士，从事神经内科疾病诊治研究。
  • 基金资助:
    保定市科技计划项目（1951ZF019）

Analysis of the risk assessment value of miR-145, ABCD2 score combined with arterial ultrasound for the progression of cerebral infarction after TIA attack

  1. Department of Neurology, the Second Hospital of Baoding City, Hebei Province, Baoding 071051, China
  • Online:2021-10-25 Published:2021-10-28

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摘要： 目的 探究微小RNA-145(microrna-145,miR-145)、ABCD2评分（age blood pressure,clinicalfeatures,durationofsymptoms,diabetes）联合动脉超声对短暂性脑缺血发作（transient ischemic attack，TIA）的患者进展为脑梗死的风险评估价值分析。
方法 选取我院神经内科收治的TIA患者132例，按照有无近进展为脑梗死分为TIA未进展为脑梗死组和TIA进展为脑梗死组，TIA未进展为脑梗死组患者76例，TIA进展为脑梗死组患者56例。2组患者均使用miR-145、ABCD2评分、miR-145+ABCD2+动脉超声检测。对比2组患者ABCD2评分；使用PT-PCR检测miR-145，使用酶联免疫吸附法检测纤维蛋白原（fibrinogen，FIB）、超敏C-反应蛋白（hypersensitive C-reactive protein，hs-CRP）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol,LDL-C）水平比较；对比观察3种检测方法的检出率、漏诊、误诊率以及诊断效能。
结果 与TIA未进展为脑梗死组相比，TIA进展为脑梗死组患者ABCD2评分上升，miR-145表达下降（P＜0.05）；FIB、LDL-C水平下降，hs-CRP水平上升（P＜0.05）；与miR-145检测和ABCD2评分检测，miR-145+ABCD2评分+动脉超声检测对TIA进展脑梗死的检出率有所上升（P＜0.05）；与检测miR-145和ABCD2评分相比，miR-145+ABCD2评分+动脉超声检测手段误诊率和漏诊率有所下降（P＜0.05）；与检测miR-145和ABCD2评分检测相比，miR-145+ABCD2评分+动脉超声检测手段的敏感度、特异度和准确度有所上升（P＜0.05）。
结论 使用miR-145、ABCD2评分联合动脉超声对TIA发作后进展为脑梗死患者进行检测，具有较高的检出率和敏感度，对TIA发作后进展为脑梗死的风险评估具有较高的价值，值得临床推广。


关键词: 脑缺血发作, 短暂性, 脑梗死, 超声检查

Abstract: Objective To explore the value of microRNA-145(miR-145), ABCD2 scores(age, blood pressure, clinical features, duration of symptoms, diabetes) combined with arterial ultrasound in the risk assessment of patients with transient ischemic attack(TIA) progressing to cerebral infarction(CI). 
Methods A total of 132 TIA patients were selected from Department of Neurology of our hospital. According to presence or absence of progression to CI, patients were divided into non-TIA progression to CI group(non-progression group, n=76) and TIA progression to CI group(progression group, n=56). In addition, the two groups were all evaluated by miR-145, ABCD2 score and miR-145+abcd2+ artery ultrasound. ABCD2 score of the two groups was compared; the miR-145 was detected by PT-PCR, and fibrinogen(FIB), hypersensitive C-reactive protein(hs-CRP), and low-density lipoprootein cholesterol(LDL-C) were compared by enzyme-linked immunoabsorbent assay. The detection rate, missed diagnosis, misdiagnosis rate and diagnostic efficiency of the three methods were compared. 
Results Compared with non-progression group, the ABCD2 score increased and the expression of miR-145 decreased in progression group(P＜0.05); FIB and LDL-C levels decreased and hs-CRP levels increased(P＜0.05). Compared with the detection of miR-145 and ABCD2 score, the detection rate of miR-145+ABCD2 score + arterial ultrasound increased in patients with TIA progressing to CI(P＜0.05). Compared with the detection rate of miR-145 and ABCD2 score, the misdiagnosis rate and missed diagnosis rate of the miR-145+ABCD2 score+arterial ultrasound test decreased(P＜0.05). The sensitivity, specificity and accuracy of the miR-145+ABCD2 score+arterial ultrasound test increased compared with the detection of the miR-145 and ABCD2 scores(P＜0.05). 
Conclusion The use of miR-145, ABCD2 score combined with arterial ultrasound to detect patients with CI after TIA attack has a high detection rate and sensitivity, and has a high value for risk assessment of CI after TIA attack, which is worthy of clinical popularization. 


Key words: ischemic attack, transient, ultrasonography

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